Thongprayoon C, Cheungpasitporn W, Gillaspie EA, Greason KL, Kashani KB. Association of blood transfusion with acute kidney injury after transcatheter aortic valve replacement: A meta-analysis. World J Nephrol 2016; 5(5): 482-488 [PMID: 27648412 DOI: 10.5527/wjn.v5.i5.482]
Corresponding Author of This Article
Kianoush B Kashani, MD, Assistant Professor, Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. kashani.kianoush@mayo.edu
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Sep 6, 2016; 5(5): 482-488 Published online Sep 6, 2016. doi: 10.5527/wjn.v5.i5.482
Association of blood transfusion with acute kidney injury after transcatheter aortic valve replacement: A meta-analysis
Charat Thongprayoon, Wisit Cheungpasitporn, Erin A Gillaspie, Kevin L Greason, Kianoush B Kashani
Charat Thongprayoon, Wisit Cheungpasitporn, Kianoush B Kashani, Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States
Erin A Gillaspie, Kevin L Greason, Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN 55905, United States
Kianoush B Kashani, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Thongprayoon C and Cheungpasitporn W contributed equally to this work; Thongprayoon C and Cheungpasitporn W contributed to performing the search, analysis and interpretation of data, analysis of data and final approval of the version to be published; Gillaspie EA contributed to critical revising of the intellectual content and final approval of the version to be published; Greason KL contributed to critical revising of the intellectual content and final approval of the version to be published; Kashani KB contributed to concept and design, critical revising of the intellectual content and final approval of the version to be published.
Conflict-of-interest statement: All authors report no conflicts-of-interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kianoush B Kashani, MD, Assistant Professor, Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. kashani.kianoush@mayo.edu
Telephone: +1-507-2667093 Fax: +1-507-2667891
Received: March 19, 2016 Peer-review started: March 22, 2016 First decision: April 20, 2016 Revised: April 23, 2016 Accepted: June 27, 2016 Article in press: June 29, 2016 Published online: September 6, 2016
Abstract
AIM
To assess red blood cell (RBC) transfusion effects on acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR).
METHODS
A literature search was performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of the databases through December 2015. Studies that reported relative risk, odds ratio or hazard ratio comparing the risks of AKI following TAVR in patients who received periprocedural RBC transfusion were included. Pooled risk ratio (RR) and 95%CI were calculated using a random-effect, generic inverse variance method.
RESULTS
Sixteen cohort studies with 4690 patients were included in the analyses to assess the risk of AKI after TAVR in patients who received a periprocedural RBC transfusion. The pooled RR of AKI after TAVR in patients who received a periprocedural RBC transfusion was 1.95 (95%CI: 1.56-2.43) when compared with the patients who did not receive a RBC transfusion. The meta-analysis was then limited to only studies with adjusted analysis for confounders assessing the risk of AKI after TAVR; the pooled RR of AKI in patients who received periprocedural RBC transfusion was 1.85 (95%CI: 1.29-2.67).
CONCLUSION
Our meta-analysis demonstrates an association between periprocedural RBC transfusion and a higher risk of AKI after TAVR. Future studies are required to assess the risks of severe AKI after TAVR requiring renal replacement therapy and mortality in the patients who received periprocedural RBC transfusion.
Core tip: We performed this meta-analysis to assess the impact of periprocedural red blood cell (RBC) transfusion on the risk of acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR). We verified a significant association between peri-procedural RBC transfusion and AKI after a TAVR with an overall 1.95-fold increased risk of AKI compared to those who did not receive transfusion. This study highlights the importance of vigilance when considering transfusions and should impact the clinical management of the high-risk group of patients undergoing TAVR.
